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What Is the Difference between Cefixime and Ofloxacin?

By Maggie J. Hall
Updated Mar 03, 2024
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Cefixime and ofloxacin have a number of differences including the mechanism by which they eradicate bacteria and the risks and side effects involved in taking the medication. While both formulations are broad spectrum antibiotics, each belongs to a different group of anti-infective agents. Cefixime belongs to the group of medications known as cephalosporins, and ofloxacin is a fluoroquinolone. Pharmaceutical companies manufacture both prescription medications in oral tablet form, but cefixime is also available as an oral suspended solution.

Inside of pathogenic organisms, cefixime binds to certain proteins, inhibiting the final stage of cell wall development. Without cell walls, internal cellular function is disrupted, and the microbe becomes vulnerable to attack. Ofloxacin inhibits enzymes that are required for deoxyribonucleic acid (DNA) replication. This action not only interferes with cellular function but also prevents microbes from reproducing. While both cefixime and ofloxacin effectively eradicate similar strains of bacteria, ofloxacin’s different chemical structure and method of killing bacteria make many microbes less resistant to it.

Patients can take cefixime with or without food but cannot take ofloxacin within two hours of consuming antacids, dairy products, or multivitamins. Didanosine and sucralfate must also be taken two hours before or after ofloxacin. Dosages of cefixime and ofloxacin also differ. Physicians typically prescribe 400 milligrams of cefixime once daily while an ofloxacin dose may be 400 to 800 milligrams per day divided into two doses and taken once every 12 hours.

Gastrointestinal side effects are common with both cefixime and ofloxacin. Patients may experience nausea, vomiting, and diarrhea. Patients with colitis or other inflammatory bowel diseases may suffer mild to severe, and sometimes fatal, symptoms as a result of taking prescription antibiotics. Patients using either drug may experience allergic or sensitivity reactions that range from mild skin irritations to dangerous swelling of the oral cavity and respiratory system.

Ofloxacin side effects include central nervous system symptoms that may include confusion, dizziness, or convulsions. Patients may also exhibit hallucinations, tremors, and increased intracranial pressure. These adverse reactions occur more frequently in patients with central nervous system disorders or in individuals who take nonsteroidal anti-inflammatory medications.

Risks associated with ofloxacin also include tendon ruptures, a danger that increases in patients using corticosteroids and in individuals over the age of 60. The rate of many adverse reactions increases if patients have heart, liver, or kidney disease. Patients with cardiac conditions may also be at risk for developing ventricular dysrhythmias, and individuals with myasthenia gravis may experience increased muscle weakness because the medication can interfere with neurotransmission at neuromuscular junctions.

Drug interactions differ between cefixime and ofloxacin. Cefixime exhibits mild to moderate interactions with approximately two dozen medications. Ofloxacin inhibits the enzymes necessary to metabolize carbamazepine or warfarin, increasing the blood levels and actions of these medications. Ofloxacin may have major interactions with twice as many medications as cefixime, including anticoagulant, antipsychotic, and oral diabetic medications. It may also react with drugs that control irregular heart rhythms.

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Discussion Comments
By stoneMason — On Mar 28, 2014

Another difference between the two drugs is that ofloxacin is a category C drug for pregnant women and cefixime is a category B drug. Also I think that cefixime is a bit more expensive than ofloxacin.

By bluedolphin — On Mar 27, 2014

@ZipLine-- That's not true. Fluoroquinolone group drugs are generally very safe and rarely cause serious side effects. In fact, fluoroquinolones are often better tolerated than cephalosporins.

Fluoroquinolone is a new group antibiotic and is effective against many different strains of bacteria. Cephalosporins are slightly older but this group of antibiotics has many generations and cefixime belongs to the newer generation so it too is effective against a wide range of bacteria.

Even though cefizime and ofloxacin do not belong to the same group (cephalosporins are similar to penicillin), they are both very effective and safe antibiotics. If you use them correctly and according to the doctor's directions, I don't think that you will have issues with either.

By ZipLine — On Mar 27, 2014

I have heard many negative things about fluoroquinolone group of antibiotics and their side effects. If I have the choice between cefixime and ofloxacin, is it better to go with cefixime?

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